Graduation Date

12-2022

Document Type

Senior Thesis

Degree

Bachelor of Science in Nursing

Primary Major

Nursing

Primary Minor

Psychology

Program Director

Andrea Boyle, PhD, FNAP

Thesis Advisor

Patricia Harris, PhD, RN

Abstract

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support during the birthing process. Nurses who know the potential effects of different positions can support the laboring mother and may be able to offer guidance to improve birthing outcomes.

Objectives

  • To compare and contrast the effects and outcomes of different laboring positions used worldwide.

  • To explore how societal norms in the United States affect the standard positions that are used today.

Methods

A literature review was performed of primary studies to examine different labor positions and methods. A meta-analysis, randomized control trials, and other well-designed studies were chosen for closer scrutiny. Different laboring positions worldwide as well as the standard methods that are used in the U.S. were investigated.

Results

In the U.S., the standard method to deliver vaginally is lying in a recumbent/semi-recumbent position to allow easy access for the healthcare providers. Studies have shown that other positions such as squatting, side-lying, or being on hands and knees can have many benefits to help the mother during delivery including easing pain, faster delivery, and better fetal and maternal outcomes. In many societies, these other positions are used routinely, but the U.S. is one of the only countries that does not use these alternative positions. Labor practices that are used in other countries may help inform care for women during labor.

Proposal for further research

The research question that then arises is: If the U.S. changes its standards of vaginal births and uses more alternative birthing positions, could there be better maternal and fetal outcomes? A study to help answer this question will be proposed.

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